NPIMap

Individual provider Active NPI

Daniel Anhua Fung, M.D

  • Physical Medicine & Rehabilitation Physician
  • Santa Monica, CA
National Provider Identifier
1619173127
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
A107358 Issued in CA
Practice address
2811 Wilshire Blvd
Suite 850
Santa Monica, CA 90403-4803
Phone
(310) 828-7757
Fax
(310) 828-6687
NPI assigned
Jun 22, 2007
Last updated
Jul 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X A107358 CA Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X A107358 CA

Addresses

Primary practice location

2811 Wilshire Blvd
Suite 850
Santa Monica, CA 90403-4803

Mailing address

2811 Wilshire Blvd
Suite 850
Santa Monica, CA 90403-4803
Phone (310) 828-7757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120928000319 CA Practitioner - Pain ManagementPractitioner - Neurology 6800045204 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Neurology
Education
Drexel University College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remote Neuromonitoring Physicians PCGroup PAC ID 1355495961, 36 clinicians
Sentient Physicians, P.C.Group PAC ID 2668764333, 37 clinicians

Practice addresses (Care Compare)

5571 Palm Dr
Hawthorne, CA 90250-5839
Phone (800) 348-4565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A107358CAMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Remote Neuromonitoring Physicians ,PC CurrentSince Aug 1, 2021 Accepting new patients
Sentient Physicians, P.C. CurrentSince Aug 1, 2021 Accepting new patients
Phyzmed Associates Inc Pain Medicine CurrentSince Aug 1, 2015 Accepting new patients
Phyzmed Associates Inc CurrentSince Aug 1, 2015 Accepting new patients

Locations

1112 Montana Ave
#900
Santa Monica, CA 90403
Phone (855) 257-4239

2801 Wilshire Blvd
Ste A
Santa Monica, CA 90403
Phone (310) 547-2777

2811 Wilshire Blvd
Ste 850
Santa Monica, CA 90403
Phone (310) 828-7757

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1619173127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 850",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-828-7757",
            "fax_number": "310-828-6687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 850",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034803",
            "telephone_number": "310-828-7757",
            "fax_number": "310-828-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNG",
        "first_name": "DANIEL",
        "middle_name": "ANHUA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-22",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "A107358",
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "CA",
            "license": "A107358",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.